相同麻醉深度下全麻联合硬膜外阻滞和单纯全身麻醉的比较

The effect comparison of general anesthesia combined with epidural block and general anesthesia at the same degree of anesthesia

目的:比较相同麻醉深度下全麻联合硬膜外阻滞和单纯全麻丙泊酚的用量及患者苏醒时间、拔管时间。方法:将40例择期行上腹部手术的患者随机均分为单纯全麻组(GA组)和全麻联合硬膜外阻滞组(GEA组),GEA组先行硬膜外穿刺后行全麻,2组均于脑电双频指数(bispectral index,BIS)在40～50时气管插管,术中丙泊酚维持BIS在40～60。记录苏醒时间、拔管时间及丙泊酚、舒芬太尼用量。结果:GEA组丙泊酚用量、舒芬太尼总用量、苏醒时间、拔管时间均少于GA组(P<0.01)。结论:在相同麻醉深度下,全麻联合硬膜外阻滞较单纯全身麻醉可减少术中丙泊酚、舒芬太尼用量,缩短患者的苏醒时间、拔管时间。

Objective：To compare the dosage of propofol and the time of patient revival and extubation of general anesthesia combined with epidural block and general anesthesia at the same degree of anesthesia. Methods：Forty patients scheduled for epigastric surgery were randomly into general anesthesia （CA group ） and general anesthesia combined with epidural block （GEA group ）. Epidural puncture was performed in GEA group after general anesthesia. Tracheal intubation of two groups were performed at the 40 to 50 of bispectral index（BIS）. Propofol was maintained at 40 to 60 of BIS during operation. The time of postoperative revival and extubation, and the total dosage of propofol and sufentanil were recorded. Results： Compared with GA group, the total dosage of propofol and sufentanil in GEA group were less（ P 〈 0.01 ）, the time of postoperative revival and extubation in GEA group were shorter（ P 〈 0.01 ）. Conclusions：At the same degree of anesthesia, GEA can decrease the total dosage of propofol and sufentanil, and short the time of postoperative revival and extubation.